| Summary: | A 64-year-old man who had lumbar spinal stenosis underwent oblique lumbar interbody fusion (OLIF) with cortical screw fixation at the L2-3, L3-4, and L4-5 levels. During the operation, there was no event of serious surgical bleeding. After the operation, he complained of severe flank pain and back pain. A computerized tomography (CT) scan identified a huge amount of retroperitoneal hematoma compressing peritoneum and the patient underwent exploration immediately. There was active arterial bleeding at the drain puncture site. The active arterial bleeding was controlled and the retroperitoneal hematoma was removed. The patient’s symptoms were recovered after the second operation. A huge amount of retroperitoneal hematoma after OLIF requiring reoperation is rare. Meticulous bleeding control and repeated inspection of the drain puncture site are critical prior to wound closure. In addition, for patients presenting with severe pain after the operation, rapid evaluation using CT and second operation is required as soon as possible.
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